Charlene S.

Charlene S. Email and Phone Number

Principal Consultant and Owner @ IT and Business Consulting Services LLC
Nashville, TN, US
Charlene S.'s Location
Nashville Metropolitan Area, United States
About Charlene S.

As an experienced Director of Technical Project Management with deep expertise in Agile methodologies and the Healthcare Payer industry, I am passionate about driving innovation, enhancing operational efficiency, and delivering impactful solutions that transform healthcare delivery. With a proven track record of managing complex, multi-million-dollar programs, my leadership is defined by strategic thinking, collaborative teamwork, and a focus on continuous improvement.Currently at Florida Blue, I lead a $40M Medicare technology program that integrates member digital experiences into healthcare platforms. This includes overseeing financial forecasting, managing project delivery, and presenting to C-suite executives. My team plays a crucial role in streamlining Medicare operations, ensuring compliance, and enhancing both agent and member portals. We've also driven key improvements in the CAHPS survey process, resulting in measurable gains for the business.Some key accomplishments include:Successfully delivering a $50M enterprise-wide IT program.Managing a $10M implementation of a healthcare analytics machine-learning platform for Medicare.Leading a $12M digital transformation project focused on enhancing member UX and streamlining the Member Portal for better benefits, claims payments, and care access.I excel in translating business needs into actionable technical solutions, driving alignment across stakeholders, and leading high-performing teams across on-site, remote, and hybrid settings. My technical and management skills span Agile and waterfall methodologies, portfolio and financial management, risk mitigation, and product strategy.Core Skills:Agile Project Management & Software Delivery (Agile, Waterfall, Hybrid)Financial Management & BudgetingCross-Functional Collaboration & LeadershipProgram & Portfolio ManagementRisk Management & Issue ResolutionStrategic Business & Product DirectionC-suite Communication & ReportingTechnical Expertise:MS Office, MS Project, MS Teams, Jira, ConfluenceAWS, ITIL® 4 FoundationSoftware Development Understanding (API/Service calls, Java, COBOL, Mainframe)Data Governance, Databases, Logical Data ModelsI am committed to driving the future of healthcare technology, creating innovative solutions, and ensuring that projects are delivered on-time, on-budget, and with lasting impact.

Charlene S.'s Current Company Details
IT and Business Consulting Services LLC

It And Business Consulting Services Llc

View
Principal Consultant and Owner
Nashville, TN, US
Website:
floridablue.com
Employees:
6602
Charlene S. Work Experience Details
  • It And Business Consulting Services Llc
    Principal Consultant And Owner
    It And Business Consulting Services Llc
    Nashville, Tn, Us
  • Florida Blue
    Sr It Program Manager - Medicare Pmo
    Florida Blue Aug 2021 - Present
    Jacksonville, Florida, United States
    Manage $40M Medicare technology program comprising approximately 15 projects (with XML, Java and HTML) and 10 Project Managers. Create and present C-Suite/Sr. Leadership reporting for monthly program financials and project delivery updates. Oversee Project Management team for various Medicare initiatives including Member Digital Experience (Customized Welcome Onboarding) Compliance, Agent Portal, Stars and Risk Adjustment, Appeals & Grievances, Claims Reporting, and CAHPS Survey. Reconcile program financials, forecast monthly spend, and track fixed program costs/expenses (using advanced Excel features)
  • Unitedhealth Group
    Director Of Operations
    Unitedhealth Group Aug 2017 - Jul 2021
    Minneapolis, Minnesota, United States
    Managed operations team (10 employees) responsible for administration of 3.5M individual Health Savings Accounts (HSA), wellness and transit plans on a vendor platform for Optum Bank w/$10B assets under management. Drove end to end solutions and business needs across enterprise applications and platforms including enrollment, claims, billing, legal, and compliance. Directed national $10M multi-year technology integration/merger between UHC & National MedTrans, a Non-Emergency Transportation (NEMT) company who provided rides for 362 million Medicaid & Medicare UHC members. Drove end to end data systems integration from onboarding, enrollment, claims processing, benefits coding, testing & encounters submissions to 16 State Medicaid agencies & MedicareOversaw development of member ride scheduling mobile application and website. Responded to RFPs for various Medicaid expansions which required in-depth knowledge of various Medicaid programs (TANF CHIP, LTSS, DSNP, ABD, ACA Medicaid Expansion).
  • Highmark Health | Hm Health Solutions
    Principal Consultant
    Highmark Health | Hm Health Solutions Nov 2016 - Jul 2017
    Pittsburgh, Pennsylvania, United States
    Headed an innovative value-based insurance (VBID) product pilot at Highmark comprised of over 10, 000 Medicare members with specific disease conditions. Responsible for the successful delivery of the $20M portfolio of Medicare IT projects Developed strategic plans short and long-range for delivery and promotion of value-based insurance products in conjunction with CMS pilot program for the health plan client. Facilitated and led cross-functional investment planning sessions with stakeholders from technology, business, compliance, product, marketing, operations and legal based on key program metrics Managed team of consultants and technology team to implement project portfolio.
  • Deloitte
    Sr. It Consultant | Pmo
    Deloitte Feb 2015 - Nov 2016
    Nashville Metropolitan Area
    Drove delivery of 15 Workplace Services applications for over 200, 000 Deloitte employees with office locations in 150 countries. Led the Win10 enterprise upgrade of 1, 500 unique desktop/mobile applications & the Deloitte Global printer software upgrade program to 2, 000 printers.Led deployments for US and international locations using Jira, Microsoft Project, Clarity and SharePoint for project management, artifacts and deliverables-Client facing role.
  • Aetna, A Cvs Health Company
    Sr. Manager | Product Engineering
    Aetna, A Cvs Health Company Jan 2007 - Feb 2015
    Hartford, Connecticut, United States
    Pioneered the Aetna/CVS $50M enterprise-wide initiative for complex regulatory systems & business process changes that were required to remain complaint with the Affordable Care Act (ACA)Championed Essential Health Benefits & Mandates Program led team which identified an enterprise compliance risk of $15M Quarterbacked $18M new health insurance product launch for Aetna/CVAdvised on healthcare claims coding, benefits setup, compliance & regulatory changes required to successfully implement the program. Successfully delivered $5M Medical Coding ICD-10 Remediation program which involved changes to 15 enterprise applications in 7 cross-enterprise departments & 20 unique third-party vendor file exchanges.Led global development teams. Functional areas: premium payments, actuarial, finance/accounting. member eligibility/ enrollment, plan setup benefits, coverages, deductibles, accumulators-member out of pocket costs, co-pays, co-insurances, welcome kits/ID cards and membership materials, compliance, legal/regulatory-insurance department filings/approvals, provider networks, claims adjudication/payments and remittances

Charlene S. Education Details

Frequently Asked Questions about Charlene S.

What company does Charlene S. work for?

Charlene S. works for It And Business Consulting Services Llc

What is Charlene S.'s role at the current company?

Charlene S.'s current role is Principal Consultant and Owner.

What schools did Charlene S. attend?

Charlene S. attended University Of Connecticut, University Of Connecticut.

Who are Charlene S.'s colleagues?

Charlene S.'s colleagues are Indrani Inapakolla, Sakibuzzaman Khan, Dixie Utley, Elizabeth Grantham, William Teller, Sarah Robst, Liam Kernochan.

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